Evidence-informed decision-making in clinical care and policy in nephrology is undermined by trials that selectively report a large number of heterogeneous outcomes, many of which are not patient-centered. The Standardized Outcomes in Nephrology−Hemodialysis (SONG-HD) Initiative convened an international consensus workshop on November 7, 2015, to discuss the identification and implementation of a potential core outcome set for all trials in hemodialysis. The purpose of this article is to report qualitative analyses of the workshop discussions, describing the key aspects to consider when establishing core outcomes in trials involving patients on hemodialysis. Key stakeholders including eight patients/caregivers and 47 health professionals (nephrologists, policy makers, industry, researchers) attended the workshop. Attendees suggested that identifying core outcomes required equitable stakeholder engagement to ensure relevance across patient populations; flexibility to consider evolving priorities over time; deconstruction of language and meaning for conceptual consistency and clarity; understanding of potential overlap and associations between outcomes; and an assessment of applicability to the range of interventions in hemodialysis. For implementation, they proposed that core outcomes must have simple, inexpensive and validated outcome measures that could be used in clinical care (quality ndicators) and trials (including pragmatic trials), and endorsement by regulatory agencies. Integrating these recommendations may foster acceptance and optimize the uptake and translation of core outcomes in hemodialysis, leading to more informative research, for better treatment, and improved patient outcomes.

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The effect on microleakage of varying the powder-to-liquid ratio (P/L) of IRM used to restore endodontic access preparations was evaluated. Crowns of noncarious, nonrestored extracted human teeth were used in this study. Microleakage was measured using a fluid filtration technique prior to access preparation to obtain control measurements. After access preparation, IRM restorations were placed using P/L of 2, 3, 4, 5, and 6 g/ml, using the manufacturer's recommended dispensing scoop and dropper, and using 2 P/L in a new capsulated IRM delivery system (IRM CAPS). Microleakage measurements were made after various time intervals and after thermal stress. The results indicated that the lower P/L provided the best seals. All groups demonstrated significant microleakage measurements after thermal stress. Significantly greater microleakage measurements were obtained with the P/L of 6 g/ml and the manufacturer's recommended dispensing scoop and dropper. A P/L of 2 g/ml demonstrated less microleakage than the other groups tested.